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Supplements are commonly used by osteoarthritis (OA) patients, and eggshell membrane (ESM) proteins are widely advertised as natural bioactive compounds for joint health. Here, we evaluated the solubility, digestibility, and immunomodulatory potential of commercial ESM supplements under physiologically relevant conditions to assess their plausibility as anti-inflammatory agents. We analyzed three commercial ESM formulations (NEM&#xae;, Torolis&#xae;, and Biova&#xae;) using standardized extraction protocols. Protein solubility was assessed in physiological saline and under simulated gastric (pH 2) and intestinal (pH 5.8) conditions with controlled temperature, agitation, and digestive enzyme exposure. We examined the role of disulfide-crosslinked proteins in insolubility using dithiothreitol (DTT) and evaluated digestibility of proteins by SDS-PAGE after treatment with pepsin, pancrelipase (Creon&#xae;), or sequential digestion. Released peptides were identified by MALDI-TOF mass spectrometry, and immunomodulatory effects were tested using human peripheral blood mononuclear cells (PBMC) by measuring cytokine release after stimulation with lipopolysaccharide or Phorbol 12-myristate 13-acetate/Ionomycin, in the presence or absence of Biova&#xae;. NEM&#xae; and Torolis&#xae; showed extremely low solubility (<&#x2009;0.3%) and remained insoluble under all conditions, including after DTT treatment. Although Biova&#xae; was highly soluble (~&#x2009;90%), simulated gastrointestinal digestion produced minimal peptide generation. Only non-physiological extraction yielded sporadic trace peptides, most lacking known anti-inflammatory relevance. In PBMC assays, Biova&#xae; increased IL-6 after lipopolysaccharide stimulation, showed a non-significant TNF&#x3b1; reduction, and had no effect on IL-17&#xa0;A or granzyme B. Together, commercial ESM supplements are largely insoluble, resistant to digestion, and show no meaningful anti-inflammatory activity in human immune cells. These findings challenge the plausibility of orally administered ESM as a therapeutic intervention for osteoarthritis.

Previous studies examined area-level differences in menthol and non-menthol cigarette prices, finding cigarettes tend to cost less in neighborhoods with lower household income, higher percentage of youth, and higher percentage of Black residents. Previous studies of store-type differences in cigarette price found lower prices in pharmacies compared to convenience stores. In a representative sample of urban cigarette retailers, this study examined differences in advertised cigarette prices by store type and neighborhood demographics. In a random sample of 1489 cigarette retailers in 26 US cities, data collectors recorded five single-pack prices: Marlboro Red and menthol (Philip Morris USA), Newport menthol and Camel Crush (RJ Reynolds Tobacco Company), and cheapest pack regardless of brand (June-August, 2022). General Estimation Equations tested differences in cigarette price (including taxes) by store type and store-neighborhood demographics. Pharmacies sold premium cigarette brands at lower prices than all other store types, except for Newport menthol in tobacco specialty shops. Associations of price with neighborhood demographics varied by manufacturer. Marlboro (Philip Morris) prices decreased as the percentage of youth in neighborhoods increased. Newport menthol and Camel Crush (RJ Reynolds) prices decreased as percentage of minoritized population increased. Price of cheapest pack decreased as the percentage of youth increased. Pharmacies were the cheapest retail source for cigarettes. With the caveat that this study is cross-sectional and observational, area-level differences in cigarette price were consistent with tobacco industry documents about marketing to youth and to racial/ethnic subgroups. Laws mandating tobacco-free pharmacies and minimum prices are recommended.

Suicide is a significant public health concern in the U.S. that has been rising steadily over the last 2 decades. Addressing substance use as a form of suicide prevention may help counteract the rising suicide rate, as alcohol and opioids are found in 22% and 20% of individuals who died by suicide, respectively. The Substance Abuse and Mental Health Services Administration envisions crisis response as addressing both substance use and suicide, including through the 988 Suicide and Crisis Lifeline. Unfortunately, few report they would contact 988 if they were experiencing a substance use issue. We sought to explore reasons for, barriers to, and likelihood of contacting 988 for substance use and inform future efforts to increase utilization. A survey of 1090 U.S. adults was conducted November 6 to 10, 2025 via the AmeriSpeak Omnibus, a nationally representative bi-monthly multi-client survey using the AmeriSpeak Panel. Only 18% of respondents reported they would contact 988 if they were experiencing substance use issues. No cost (41%), immediate support while on a wait list for treatment (32%), and avoiding stigma (32%) were the most commonly reported motivators for contacting 988 for substance use support. Being advertised as a suicide and crisis lifeline (22%), lack of follow-up (14%), and lack of training among counselors (13%) were reported as barriers. Familiarity with 988 was associated with likelihood of contacting 988 for substance use support for at least 1 listed reason (81% of those extremely/very familiar vs 51% not very/not at all familiar). Responses varied by education, gender, race/ethnicity, and age. Findings identified factors that influence the public's likelihood of contacting 988 for substance use support and suggest a need for standardized substance use intervention protocols and targeted messaging tailored to specific audiences.

Animal interaction programs (AIPs) are a sub-category of animal-visitor interactions (AVIs) and are increasingly prevalent across accredited zoos worldwide. Although AVIs are being increasingly researched, few studies have explored the welfare implications of AIPs, such as the potential animal welfare impacts of public feedings or public presentations. Bird shows and presentations are among the most2021a advertised AIPs within zoological institutions yet suffer from a lack of empirical studies. This study investigated behavioral and physical measures to assess the welfare of several bird species located at Adelaide Zoo. An ethogram was developed to record behaviors across three comparisons: (1) show days versus non-show days, (2) before and after shows, and (3) show birds versus non-show birds. In addition, feather and body condition scores were recorded and compared across show birds and non-show birds. Multiple comparisons were provided in an attempt to avoid limited and context-specific data, which assisted in a more comprehensive and well-rounded welfare assessment. Show birds demonstrated an increase in abnormal behaviors on show days compared to non-show days, which prompted further comparisons to determine why the increased prevalence of abnormal behaviors was occurring on the days a presentation took place. On presentation days, show birds demonstrated more active, social, and abnormal behaviors pre-show but exhibited an increase in grooming, foraging, and a significant reduction in abnormal behaviors post-show, which could suggest a potential anticipatory effect. In addition, show birds had a closer-to-ideal body condition score and demonstrated significantly less inactive and abnormal behavior compared to non-show birds. The results suggested that public bird shows and presentations have a largely minimal or neutral welfare impact, however, there may be a potential enriching aspect of bird shows and presentations.

Single-cell foundation models such as scGPT have been promoted as representations of gene regulation, but their advertised regulatory signal has been judged largely from attention weights, which are correlational. We ask a deliberately bounded question: whether direct interventions on scGPT gene tokens-causal with respect to the model's own computation-recover model-internal transcription-factor (TF)-target dependencies that align with curated references, whether that signal is robust, and whether it transfers to real perturbation responses. We separate these into two explicit validation axes and report both, including where the model-internal signal does not correspond to biological causality. On Tabula Sapiens kidney, lung, and immune subsets, plus an external Krasnow lung atlas and three CRISPR perturbation datasets (Adamson, Dixit, Shifrut), we ablate or swap TF token values inside scGPT and quantify changes in target-token readouts. Axis 1 (reference alignment): intervention scores are evaluated against curated TRRUST and DoRothEA references and against attention and coexpression baselines, with new robustness studies over cell count (120-500), positive/negative pair count, four negative-sampling designs, and four readout strategies (mean, L2, cosine, max). We trace component-level circuits via activation patching, and benchmark against twelve GRN inference methods including a neural-network baseline on a matched substrate, additionally giving the classical methods larger cell budgets to test the equal-information question. Axis 2 (perturbation transfer): scores are evaluated against CRISPR perturbation-derived edges under balanced labels and AUROC. On Axis 1, lung shows reproducible enrichment that is stable across cell count and survives all four negative-sampling designs (permutation p improving from 0.07 to 0.03 as cells grow from 120 to 500); kidney enrichment is significant at small samples but does not survive scaling (permutation p rising to 0.16 at 500 cells); immune is at baseline. Richer readouts (L2, cosine) recover signal the scalar mean compresses away, particularly in kidney. On the matched benchmark scGPT leads classical and neural baselines at the shared 120-cell budget, but the lead narrows as the classical methods are given more cells, confirming this is a signal-efficiency result, not general superiority. On Axis 2, balanced evaluation of all three CRISPR datasets, including the TF-screen Dixit data, yields AUROC&#x2006;&#x2248;&#x2006;0.50: the model-internal signal does not predict real perturbation responses. scGPT encodes tissue-conditional, intervention-sensitive regulatory structure that is aligned with literature-curated TF-target edges (robustly in lung) but is representational rather than biologically causal: it does not transfer to perturbation outcomes. The pipeline is a practical mechanistic-audit toolkit for biological foundation models, and the gap between reference alignment and perturbation transfer is a concrete cautionary result for using such models in regulatory inference.

Cannabis cue reactivity paradigms are instrumental in studying the behavioral and neurocognitive mechanisms of cannabis use and cannabis use disorders; however, image sets used for cannabis cue reactivity paradigms vary between studies, and the lack of reliability and validity assessment hinders the quality of evidence they generate. The main aim of this study was to create a novel, open access, standardized and representative database of cannabis use-related images including control images matched by resolution, luminosity and complexity: The Cannabis Research Image Database (CRESIDA). The secondary aim was to examine whether subjective cannabis cue-induced craving was associated with cannabis use severity and whether this relationship was moderated by image type. As an illustrative example of how our open data can be used and how sample characteristics can shape cue reactivity, we also explored the role of cannabis-tobacco mixing by comparing cannabis cue induced cannabis and tobacco craving between individuals who did and did not mix the substances. An online survey was administered to participants recruited via online platforms, community advertisement and snowballing. USA, the Netherlands and Australia. 689 participants who consumed cannabis monthly to daily (385 men, 298 women, 6 other) were recruited between January 2022 and May 2024. Out of 93 cannabis images and 93 matched neutral images, participants each rated 31 image pairs for cannabis craving (the primary outcome), arousal, valence and tobacco craving. Participants were characterized for socio-demographic data, level of cannabis use and related problems and mixing cannabis and tobacco. A subset of 78 images was selected for further analysis based on cannabis craving results. Image ratings were evaluated for internal consistency (&#x3b1;). Furthermore, we examined the association between cannabis cravings and cannabis use characteristics, and explored if cannabis craving ratings were affected by image type (i.e. product, paraphernalia and actions) and by using cannabis alone vs. mixing cannabis and tobacco. The database showed excellent reliability (&#x3b1;&#xa0;=&#xa0;0.995-0.965). Cannabis craving, valence and arousal discriminated cannabis and control images. More cannabis use days [unstandardized beta (&#x3b2;)&#x2009;=&#xa0;0.162, P&#x2009;<&#x2009;0.001] and cannabis use-related problems (&#x3b2;&#x2009;=&#xa0;0.268, P&#x2009;<&#x2009;0.001) were statistically significantly associated with higher image-related cannabis craving. Mixing cannabis with tobacco, compared with using cannabis alone, was associated with the presence of tobacco craving in relation to cannabis images, and with greater cannabis craving in relation to cannabis images (&#x3b2;&#x2009;=&#x2009;-0.457, P&#x2009;<&#x2009;0.001). Images in the open access Cannabis Research Image Database (CRESIDA, https://osf.io/dc9nz/) appear to be reliable and valid for the scientific study of cue reactivity internationally, providing a broad range of free to use cannabis and control images.

In 2021, Bristol, UK, implemented a city-wide policy restricting advertising of unhealthy commodities on council-owned sites. We aimed to describe advertising exposure before and after the implementation of the policy in Bristol. We collected data from bus shelters in Bristol (N&#x2009;=&#x2009;283) and neighboring South Gloucestershire (SG, comparator, N&#x2009;=&#x2009;65), using in-person and Google Street View audits, before (T0, 02/2022 - 07/2022) and after (T1, 04/2023 - 07/2023 and T2, 11/2023 - 02/2024) policy implementation. We captured unhealthy commodity adverts on display; high in fat, sugar or salt (HFSS) products (defined using the UK Nutrient Profiling Model), alcohol, gambling or payday loans; information on brands; whether they appealed to children or adolescents and split analyses by area deprivation and proximity to schools. At T0, unhealthy commodity advertising in both areas was relatively low, however the policy successfully reduced unhealthy commodity advertising in Bristol at T2 (11.3% to 0.8%), compared to an increase in SG (0.9% to 18.1%). Most restricted adverts in both areas displayed HFSS products (ranging 60-100%), especially fast food, with limited alcohol and gambling and no payday loan advertising observed. A few adverts displaying non-compliant products were maintained in Bristol but advertisers also switched to advertising alternative, compliant products. Minimal unhealthy commodity advertising appealed to children/adolescents (1.1-8.8%) or appeared within 100m of schools (N&#x2009;=&#x2009;2 adverts), and no clear association with area deprivation was found. Findings suggest the need for formal monitoring processes to ensure policy adherence and assess unhealthy commodity advertising in the entire outdoor space to inform potential expansion of such policies.

Hospitalization can disrupt patients' communication and social connections, potentially contributing to social isolation, while the supportive role of family and friends in communication is often underrecognized. This study examines communication access barriers and their association with social isolation among hospitalized patients, based on reports from family and friends. A cross-sectional online survey of family/friends across Canada (N&#x2009;=&#x2009;179) was conducted to examine patient communication and social isolation. The questionnaire was distributed via Facebook advertisements (Meta Ads Manager) and administered through SurveyMonkey (February 14-28, 2025). Descriptive and inferential analyses were conducted. Most respondents (Family and Friends) were female (78.8%) and were aged 40-49 years. Respondents reported that in-person communication was preferred (67.9%), and 58.5% shared communication responsibilities with patients and hospital staff. However, only 11.2% reported consistent staff communication support, and 5.9% reported reliable device access. Key barriers included lack of independent access to devices (23.5%), poor Wi-Fi (17.5%), and privacy concerns (16.1%). Fewer believed that communication challenges were prioritized equally with physical care (19.1%). Communication gaps were associated with social isolation. Inadequate support increased reported social isolation (odds ratio [OR]&#x2009;=&#x2009;4.03, 95% confidence interval [CI]: 1.83-8.85), and patients whose communication concerns were not prioritized had greater odds of feeling social isolation (OR&#x2009;=&#x2009;3.49, 95% CI: 1.12-10.83). Based on family and friends' reports, communication barriers in hospitals are common, despite patients having active social networks. Limited staff support, challenges with independent device use, and Wi-Fi issues highlight modifiable gaps in hospital communication infrastructure.

Involving community members with lived experience of social issues or services is crucial to improve social work education, however no published studies have examined this specifically within simulated learning environments. This study examined student perspectives on community member involvement in simulations. This quantitative and qualitative study surveyed current and alumni Bachelor of Social Work students about their perspectives of engaging in simulations with community members through an online questionnaire. Sampling was purposive from a target of 200 students reached through online advertisement. Fifty-eight responses were received. Descriptive statistics were used to summarize the data, inferential statistics (t-test and ANOVA) to compare groups, and Cohen's d to assess effect size, while thematic analysis was applied to qualitative data. High mean scores indicate that simulations were perceived as effective in preparing students for real practice (M&#x2009;=&#x2009;8.34), more impactful than role plays (M&#x2009;=&#x2009;8.54), and increased awareness of diversity and difference (M&#x2009;=&#x2009;7.64), cultural sensitivity (M&#x2009;=&#x2009;7.53), and comfort working with the community (M&#x2009;=&#x2009;7.16). Themes reflect the benefits and challenges of having real-life situations in the classroom. Students valued the authenticity of lived experience knowledge as central to their learning. Read through a decolonial lens, results represent a challenge to the epistemic hierarchies that have historically determined whose knowledge counts in education. Social work programs must move toward building sustained, equitable, accountable and reciprocal partnerships with communities. Future research could target a larger sample to increase generalizability of findings.

Queer Asian American men face pervasive experiences of racism in romantic and sexual contexts (i.e., sexual racism), which may heighten their risk of developing disordered eating concerns. Moreover, geosocial networking apps (GNAs) used by queer men are a pertinent risk factor for disordered eating attitudes and behaviors. Nevertheless, no studies have examined the links between GNAs, racially relevant factors, and disordered eating among queer Asian American men. Hence, grounded in intersectionality theory and the racially expanded model of objectification theory, the present study investigates the associations between GNA intensity and GNA sex-seeking with disordered eating through sexual racism and internalized racism sequentially. Participants were recruited through Prolific. Our final sample consisted of 265 queer Asian American men whose ages ranged from 18 to 65 (M&#x2009;=&#x2009;28.42, SD&#x2009;=&#x2009;8.32). All analyses were conducted through SPSS (v.29). Serial mediation analyses indicated that GNA intensity was indirectly associated with greater disordered eating through sexual racism and internalized racism sequentially (B = 0.028, SE = 0.013, 95% CI [0.008, 0.058]). Similarly, GNA sex-seeking was indirectly associated with greater disordered eating through sexual racism and internalized racism sequentially (B = 0.061, SE = 0.026, 95% CI [0.018, 0.118]). As queer Asian American men engage with GNAs intensively and for sex-seeking purposes, it is possible that they may face sexual racism and subsequently experience internalized racism, which consequentially is associated with greater disordered eating. Social justice-informed implications are discussed. For instance, GNAs may consider implementing educational advertisements to inform users of the pervasiveness of sexual racism and antiracist policies that integrate features that flag and remove profiles or interactions with racist language. The disordered eating literature has scarcely centered the experiences of queer Asian American men, who face a heightened risk for disordered eating attitudes and behaviors due to intersectional axes of oppression. Specifically, experiences of racism in romantic and sexual contexts, otherwise known as sexual racism, have been linked to disordered eating among this community. In this sample of 265 queer Asian American men, we found that as queer Asian American men use online dating/hookup apps intensively and for sex-seeking purposes, they may face sexual racism and, subsequently, experience internalized racism, which increases their risk for disordered eating. Our study highlights online dating/hookup platforms as a potential factor associated with disordered eating among queer Asian American men through sexual racism and internalized racism. Disordered eating interventions may integrate social justice-informed frameworks that address racial oppression to reduce disordered eating attitudes and behaviors among queer Asian American men. Furthermore, online dating/hookup apps may implement prevention efforts to preclude the onset of disordered eating by applying anti-racist policies that target sexual racism experiences, as well as disseminating psychoeducational advertisements that provide consciousness-raising strategies to combat internalized racism.

The layout of the image and the positional distribution of the objects directly affect the audience's visual focus and the effect of the message conveyed. By setting up a specific layout structure, the viewer's attention can be more focused on the product launched or the moral of the advertisement. Existing work related to position-controllable text-to-image&#xa0;generation has made great progress in generating results on simple images. However, when generating images of complex scenes, the quality is often poor. This can result in the model failing to accurately convey the message of the advertisement when used to generate advertisements. To address these limitations, we propose LAYOBJ-GAN, a novel two-stage framework for layout-controllable advertisement image synthesis. Unlike prior work, our method explicitly models background layouts jointly with object layouts during the text-to-layout generation stage, enabling comprehensive spatial planning of complex scenes. Technically, we introduce a Transformer-based sequence-to-sequence layout generator that learns long-range dependencies between textual descriptions and both background and object regions, which has not been explored in previous advertisement-oriented text-to-image frameworks. In the layout-to-image stage, we further propose a fine-grained text-layout interaction normalization module (TL-Norm) that enables object knowledge transfer from a pre-trained category-to-image model, allowing object appearance to be adaptively modulated by textual context and layout constraints. Extensive experiments on MS-COCO and a high-definition advertisement dataset (AsHQ-10K) demonstrate that LAYOBJ-GAN significantly outperforms seven state-of-the-art methods in image quality, layout controllability, and semantic object accuracy. These results confirm the effectiveness of explicitly modeling background layouts and transferring object-level generative knowledge for complex advertisement image synthesis.

The Transformative Research on Equity And Social determinants to Uplift Resilience and Empower LGBTQ+ Health in China (TREASURE) is the first large-scale cohort study designed to investigate health conditions and social determinants of health among the LGBTQ+ population in China. The TREASURE cohort study was developed in close collaboration with community-based organizations, ensuring culturally appropriate study procedures and improved inclusion of hard-to-reach populations. Participants were recruited through co-created, multi-channel strategies, including on-site recruitment, community outreach, WeChat advertising, and social network referrals. Eligible participants were individuals aged 16 years and older, who self-identified as LGBTQ+&#x2009;and resided in Chengdu or had primary LGBTQ+ social activities in the area. From August 2023 to November 2025, 10,093 participants enrolled in the baseline investigation from Chengdu City and surrounding areas including cisgender gay men (47.9%), cisgender lesbians (19.0%), cisgender bisexual individuals (5.8%), transgender participants (13.3%), and queer or questioning individuals (14.1%). The first round of cohort follow-up was conducted 12 months after the baseline and every two years thereafter. The baseline survey collected comprehensive data on sociodemographic information, sexual orientation and gender identity related experiences, psychosocial factors, health outcomes, and other topics of interest. Follow-ups are designed to obtain repeated measurements of sociopsychological determinants and health outcomes, as well as additional information on health service needs. The TREASURE cohort documents a substantial burden of psychosocial adversity among LGBTQ+ individuals in China, including high levels of trauma exposure, SOGI-related discrimination and violence, depressive symptoms, PTSD symptoms, suicide risk, and other adverse health outcomes.

Digital media has emerged as a vital tool for the rapid dissemination of public health information to vast audiences. During the COVID-19 pandemic, social media-based health communication kept audiences informed, encouraged health-seeking behaviors, and helped address rampant misinformation. However, the impact of these digital communications was limited by a lack of training in leveraging online advertising tools, behavioral insights, and marketing practices to target, test, and scale social behavioral communications for health. The COVID-19 pandemic highlighted an urgent need for greater capacity among public health organizations to rapidly develop and deploy impactful, evidence-based digital campaigns. This study aimed to evaluate changes in learner confidence and perceived ability to implement key skills after taking a massive online open course on digital campaign creation. Digital Media for Health Outcomes was launched in May 2023 to train public health practitioners in all steps of campaign development, from evidence and insights collection to outcome evaluation. In April 2025, course performance was evaluated using a pre-post survey design. Learners were asked to complete identical surveys before and after completing the course. Question topics included basic demographic information and learners' confidence and experience in applying key campaign development skills. Learners were also asked to rate their confidence in using digital media to drive health outcomes before and after taking the course, and their perceived importance, ease, likelihood, and effectiveness of doing so. Proportions and 95% confidence intervals were calculated for confidence questions, and proportion changes were compared between the baseline and endline surveys. All analyses were conducted using Stata (Special Edition 18; StataCorp). As of April 2025, the course had enrolled 14,170 individuals in 9 language versions, representing over 160 unique countries from all global regions. A total of 4392 learners completed the baseline survey, and 634 completed the course and endline survey. Most course completers came from Chile (240/634, 38%) and the United States (69/634, 11%). Learners who completed the course reported significantly higher confidence (+18%, 95% CI 17%-20%) in their perceived ability to use digital media to drive health outcomes and in applying skills associated with effective campaign development, including leveraging behavioral insights (+16%, 95% CI 14%-18%) and evaluating campaign outcomes (+28%, 95% CI 26%-29%). Overall, 92% (583/634) of course completers felt that the course had met most, all, or exceeded their expectations, and 85% (539/634) indicated that they would recommend the course to a colleague. Performance evaluation of the Digital Media for Health Outcomes course suggests the potential of an expert-led, practice-based massive open online course to improve confidence and skill level in leveraging digital media for effective health communication among public health professionals. Further capacity strengthening is needed to encourage skill application.

Tobacco consumption gets normalized with its positive portrayal through tobacco advertisement, promotions and sponsorship (TAPS) of tobacco products, to initiate or catalyze consumption. While the Cigarettes and Other Tobacco Products Act, 2003 (COTPA) bans TAPS in India, it is prevalent through social media, cable television, sponsorship of cricket matches, music or award shows, school or college events, etc., and through brand stretching to nontobacco avenues like consumer goods, hotel chains, etc., COTPA shows internal inconsistencies in its short title, preambular aim, and provisions, which carve out an exception for advertising at points of sale. Ban's implementation is also limited due to the expensive action-taking mechanism and limited fines. These lacunae are further exacerbated by the inconsistencies of COTPA with other laws governing trademarks, cable television, food safety, consumer protection, etc. that allow for the advertisement of cobranded products of tobacco companies. To address TAPS comprehensively in India, these inconsistencies need to be redressed, arguably through legislative amendments in COTPA and allied laws, better implementation mechanisms, simplifying seizure of evidence for presentation in courts, and prioritizing public health over commercial interests of tobacco companies in the judicial pronouncements.

Metabolic dysfunction-associated steatotic liver disease (MASLD), causing cirrhosis and liver cancer, is prevalent worldwide. Analyses of internet searches for "fatty liver" and methods to raise MASLD awareness are needed. We retrospectively analyzed co-occurring terms with "fatty liver" and tracked search histories to identify key terms. In a comparative study, a banner advertisement about MASLD was shown to individuals searching for key terms (key term group: KTG) or regardless of the search terms (control group: CTR). The ad redirected viewers to an educational cartoon, followed by a questionnaire. The most frequent co-occurrence term was "how to treat." People searched mainly for lifestyle-related disease and diet terms. Key terms included "diet," "blood sugar level," "cholesterol," "triglyceride," "visceral fat," and "antihypertensive drugs." Banner views were 5&#x2009;864&#x2009;184 for KTG and 49&#x2009;388&#x2009;176 for CTR. KTG had a higher click-through rate than CTR (0.097% vs. 0.063%; p&#x2009;<&#x2009;0.001) and more survey responses (3.22% vs. 0.84%; p&#x2009;<&#x2009;0.001). KTG participants also had a greater intention to seek medical care early (60.2% vs. 42.4%; p&#x2009;=&#x2009;0.003). Search term-based advertising may help increase public awareness of MASLD and may encourage earlier intention to seek medical consultation.

Australia is reporting increasing notifications of sexually transmitted infections (STIs). Effective control depends on timely and equitable testing. However,&#xa0;evidence of testing and diagnosis patterns across diverse populations is limited. This study aimed to describe STI testing and diagnosis by different demographics in Victoria. A&#xa0;12-month online survey in Victoria, Australia recruited individuals aged 16&#xa0;years and older through the Melbourne Sexual Health Centre, the Centre for Excellence in Rural Sexual Health, targeted social media advertisements, and community digital outreach. Data was collected on self-reported STI testing (blood, swab, urine, or no test) and STI diagnosis in the past 12&#xa0;months. Subgroup analyses examined differences by age, residential location, and population groups. Chi-squared tests were used to compare the proportions of STI testing and diagnosis across different subgroups. We included 2327 participants in this analysis. Overall, 50.2% of participants reported blood testing, 39.8% swab testing, 47.3% urine testing, and 41.0% did not have any HIV/STI test in the past 12&#xa0;months. In total, 17.3% reported an STI diagnosis. Participants in regional Victoria were more likely not to test (54.0%) compared with those in greater Melbourne (40.0%). The proportion with no testing was lowest among gay and bisexual cis-men (10.5%) and highest among heterosexual cis-men (57.1%). The proportion with no testing declined significantly with age from 72.7% among those aged 16-19&#xa0;years to 52.4% at 20-24&#xa0;years. Inequities in STI testing and diagnosis persist across age, population groups,&#xa0;and geography. Further research is needed to identify structural and behavioural barriers and to guide strategies that ensure equitable access to timely STI care.

The tobacco industry has aggressively marketed menthol tobacco products because they are less harsh and more appealing to youth and other non-users. US law prohibits most flavours in tobacco products but exempts menthol from the ban. In 2020, California enacted a state law prohibiting retail sales of most flavoured tobacco products with 'characterising flavours', including menthol. Major tobacco companies vigorously opposed the law and sought its repeal. Despite spending millions of dollars to try to influence the legislature, ballot box and courts, the tobacco industry sought to evade the law by introducing so-called 'non-menthol' cigarettes. We describe those industry efforts and California's responses: California law was amended to redefine illegal flavoured products to include those that create a 'cooling sensation' to consumers and established an unflavoured tobacco list making it illegal for retailers to sell flavoured products not on the list. The California experience described in our paper provides a case study demonstrating some best practices that can be replicated by other US states and localities and other countries consistent with the WHO Framework Convention on Tobacco Control.

The nationally advertised mass media campaign Act-FAST UK, delivered in multiple waves since its launch in 2009, has increased public awareness of stroke symptoms. However, many stroke patients still delay in calling for help and reach the hospital too late to receive emergency treatments. The reasons for this cognitive dissonance between recognition of symptoms and urgent seeking of emergency medical services (EMS) are unclear. This study aimed to quantify cognitive, psychological, and knowledge-based barriers to help-seeking in patients with acute stroke or transient ischaemic attack (TIA), as well as in intervening witnesses, and to examine their association with the use of EMS as the initial point of contact. We interviewed patients admitted to a hyperacute stroke unit with a stroke or transient ischaemic attack (TIA) from 2013 to 2016. People who contacted emergency services on the patient's behalf (intervening witnesses (IWs)) were also interviewed when available. Reasons given for delays in calling for help were related to correct symptom recognition, and whether/at what time, emergency services were contacted after symptoms onset. A total of 602 patients (429 with stroke, 173 with TIA) along with 128 witnesses who intervened in calling for help in those cases (IWs) were interviewed. In the subset of patients with both measures available, there was a strong positive correlation between NIHSS score and number of FAST symptoms (Spearman's rho = 0.645, p < 0.001), providing supportive evidence for the use of FAST symptom count as a proxy measure of stroke severity. A total of 469 (77.9%) of the patients were aware of a media education campaign about stroke, but only 145 (24.1%) had attributed their own symptoms to stroke at onset. However, correct self-diagnosis of stroke was not associated with direct calls to the EMS (OR 1.43, 95% CI 0.84-2.45). Cognitive, psychological or emotional barriers to help-seeking, as reported by prior published studies, were reported by 463 (81.2%) of the patients we interviewed but in only 63 (53.3%) of the IWs (p < 0.001). Amongst the patient cohort, "not thinking symptoms were serious" (275, 45.7%) and "waiting to see if symptoms would go away" (285, 47.3%) were most strongly negatively associated with EMS use (OR 0.52, 95% CI 0.32-0.84 and OR 0.34, 95% CI 0.21-0.55, respectively). Only 55 (9.1%) of the patients interviewed had been aware of any time-critical stroke treatment prior to their stroke. Eighteen stroke patients (4.2%) reached hospital in time to receive thrombolysis, but an additional 170 (39%) could have been considered for this treatment (i.e., had no apparent other contraindications from a notes review) had they arrived within 4 h of symptom onset. Future public education campaigns may be more effective if they specifically address factors associated with delays in calling for help after stroke symptoms and emphasise the existence of emergency treatments, which are also time-critical. More effective public education may have the potential to increase the proportion of patients arriving in time to benefit from such treatments.

Musculoskeletal (MSK) conditions are the leading cause of global disability, placing a substantial burden on healthcare systems. Internationally, Advanced Practice Physiotherapy (APP) has shown promise in alleviating this burden; yet systemic barriers limit its integration in Canada. Understanding the perspectives of patients and multidisciplinary clinicians with direct experience in an APP-led MSK model can inform strategies for sustainable implementation. To understand and integrate the perspectives of multidisciplinary clinicians and patients on an APP-led MSK model in Canada. A qualitative descriptive study conducted within a pragmatic paradigm and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research. All clinicians involved in the APP-led model were invited to participate. Patients seen within the model during recruitment were consecutively invited verbally or through advertisement. Focus groups were used for data collection. 2 researchers conducted content analysis to generate descriptive themes, followed by thematic synthesis to integrate findings. 4 key themes were identified from 2 patient (n&#x202f;=&#x202f;8) and 2 clinician focus groups (n&#x202f;=&#x202f;12): 1) collaboration is a pathway to acceptance, optimal patient care and professional growth, 2) broad agreement on the positive impact for patients and the healthcare system, 3) challenges remain to be addressed and 4) potential opportunities exist to improve the model. APP-led MSK care was supported by patients and clinicians, but broader implementation is constrained by gaps in standardized education and enabling policy structures. Addressing these system-level barriers may support sustainability and maximize the impact of APP in MSK care in Canada.